Herbal Health

If a drug is to be taken reliably and regularly, a patient must be informed fully about that drug. A plan of the proposed management and possible side-effects of the anti-epileptic drug must be discussed with the patient (or family) at diagnosis and at the outset of treatment. In the children’s seizure clinic at the Royal Liverpool Children’s Hospital (Alder Hey) and at St. Bartholomew’s Hospital, families are provided with a drug information sheet with written details about the drug. Included is information about:

• its preparation (e.g. tablet, capsule, or liquid);

• the method of administration;

• the dosage regime;

• its possible interactions with drugs bought over the counter in chemist’s shops as well as with other prescribed drugs; and

• its side-effects.

Advice is also given regarding what to do about doses which are forgotten, missed, or vomited.

Written information is in addition to, rather than a substitute for, oral advice. Patients often do not remember, or may misunderstand, much of what is said to them by doctors in a busy hospital clinic or surgery. This is particularly relevant with regard to adverse events or side-effects. Unexpected side-effects may distress or annoy patients (and their families) and thus adversely affect whether they will continue to take the drug, with its potential benefits. Patients should also be warned that different, or additional drugs may be needed depending on the specific epilepsy syndrome and their initial response to treatment. Well-informed patients and families are more likely to use their drugs with discretion and obtain the benefits which modern drugs can offer.

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Diabetes was another early puzzler. Many physicians began reporting that diabetic patients taking CMO for arthritis were requiring less insulin. I checked into that mystery personally and found that a substantial percentage of diabetics suffer from autoimmune destruction of the pancreatic cells that produce insulin. It seemed reasonable to conclude that CMO was intervening in those attacks, saving the insulin-producing cells from destruction and allowing the generation of new cells to continue undisturbed.

Although vitamin E does not help pancreatic cells produce more insulin, daily use is known to reduce plasma glucose, triglycerides, free fatty acids, and cholesterol. It has been suggested that the use of vanadyl sulphate can greatly improve the effectiveness of insulin.

Studies are needed to determine if a protocol for the effective treatment of diabetes using CMO can be developed. We would welcome the participation of other clinics and physicians.

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Signs and symptoms

The turning in of the toes is easy to see; if the condition persists, it should be brought to the doctor’s attention. You can do a preliminary test for an adductovarus deformity of the foot by laying a straightedge along the outer border of the child’s foot. If the outer border of the foot is not absolutely straight from the heel to the little toe, the child has adductovarus deformity. To discern tibial torsion, place the infant or child on his or her back with the legs straight out, kneecaps pointed upward, and feet at right angles to the lower legs. If the toes point toward the midline instead of straight up, the child may have tibial torsion.

Femoral torsion or anteversion usually does not appear until age four or five; from then on it gradually worsens. It can be detected by rotating the thighs at the hip joint. If the thighs make a larger arc internally than externally the child has femoral torsion.

Home care

By three months of age, your infant will prefer to sleep with the toes directed outward. This position is normal and should be encouraged. When the child is old enough to sit upright, the feet should be straight or turned outward. Until 18 to 24 months, your toddler usually will walk with one or both feet turned outward; this gives the child a wider base and better balance, and is normal. A tendency to toe in after three months of age should be called to your doctor’s attention.

Precautions

• An uncorrected adductovarus deformity makes it very difficult to fit the child’s shoes properly; this may eventually lead to the child developing a skewed foot and bunions in adolescence or adulthood.

• A child who sits on the floor a lot should be taught to sit cross-legged, not on his or her haunches with the toes directed outward.

• Corrective orthopedic shoes should be prescribed only by a medical professional, never by a shoe salesperson.

• Most minor cases of pigeon toes correct themselves. Nevertheless, let a doctor judge if the condition is minor or not.

Medical treatment

Your doctor will observe the child while he or she stands and walks both with and without shoes. The feet, the lower and upper legs, and the rotation of the hips will be examined. If necessary, your doctor will instruct you in massaging your child’s feet to correct mild toeing-in. If this massage does not correct the condition by the time the child is three or four months old, your doctor will order specific kinds of shoes or plaster casts. To correct tibial torsion, the doctor may prescribe a splint that holds the feet outwardly rotated while the child sleeps. In the case of femoral anteversion the doctor may not start treatment until your child is a teenager. If the condition has not corrected itself by that time, surgery on the thigh bones may be necessary.

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